异基因造血细胞移植后巨细胞病毒再激活的预测因素：来自真实世界经验的启示。

IF 1.6 4区医学 Q4 IMMUNOLOGY

Transplant immunology Pub Date : 2024-03-19 DOI:10.1016/j.trim.2024.102039

Matthew McGuirk, Moazzam Shahzad, Muhammad Kashif Amin, Muhammad Atif Khan, Polina Bellman, Dinesh Pal Mudaranthakam, Shaun DeJarnette, Forat Lutfi, Nausheen Ahmed, Rajat Bansal, Haitham Abdelhakim, Chelsea Gorsline, Dennis Matthew Shoemaker, Al-Ola Abdallah, Leyla Shune, Sunil H. Abhyankar, Anurag K. Singh, Joseph P. McGuirk, Muhammad Umair Mushtaq

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引用次数: 0

摘要

背景：我们旨在研究巨细胞病毒（CMV）病毒血症和CMV疾病的相关因素及其对移植后预后的影响，包括异基因造血干细胞移植（Allo-SCT）后的总生存期（OS）：我们开展了一项单中心回顾性研究，研究对象包括2016年至2021年的452名异体干细胞移植受者（配型无关供者，MUD占61%；单倍体，haplo占39%）。数据使用 SPSS v28 进行分析。进行了描述性分析（卡方检验和t检验）、Kaplan-Meier分析和回归分析：中位年龄为 57 岁。61%为男性，84.3%为白种人。59.1%的受者CMV血清反应呈阳性。中位随访时间为 24.4 个月。分别在 181 名（40%）和 32 名（7%）患者中观察到 CMV 病毒血症和 CMV 疾病。在CMV血清反应阳性的受者中，65%出现了CMV病毒血症，11%出现了CMV疾病，而在血清反应阴性的受者中，CMV病毒血症和CMV疾病的比例分别为4%和1%（P 结论：CMV疾病会显著降低受者的生存率：CMV疾病会导致异基因造血细胞移植后的存活率明显降低。受者的CMV血清反应阳性与CMV病毒血症和CMV疾病的风险有关，而且使用来替莫韦后也不会减轻这种风险。

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Predictors of cytomegalovirus reactivation after allogeneic hematopoietic cell transplantation: Insights from a real-world experience

Background

We aimed to investigate factors associated with cytomegalovirus (CMV) viremia and CMV disease and its impact on post-transplant outcomes including overall survival (OS) following allogeneic hematopoietic stem cell transplantation (Allo-SCT).

Methods

We conducted a single-center retrospective study including 452 Allo-SCT recipients (matched unrelated donor, MUD 61%; haploidentical, haplo 39%) from 2016 to 2021. Data were analyzed using SPSS v28. Descriptive (chi-square and t-test), Kaplan-Meier and regression analyses were conducted.

Results

The median age was 57 years. Sixty-one percent were males and 84.3% were Caucasians. CMV serostatus was positive in 59.1% of recipients. The median follow-up was 24.4 months. CMV viremia and CMV disease were observed in 181 (40%) and 32 (7%) patients, respectively. Among CMV seropositive recipients, 65% developed CMV viremia and 11% were noted to have CMV disease compared to 4% and 1% in seronegative recipients, respectively (p < 0.001). Patients with CMV disease had significantly lower OS than those without CMV disease (median 14.1 months vs. not reached, p = 0.024); however, OS was not associated with CMV viremia (median not reached in both groups, p = 0.640). Letermovir prophylaxis was used in 66% (n = 176/267) of CMV seropositive recipients, but no impact was observed on the incidence of CMV viremia or CMV disease and OS.

Conclusions

CMV disease leads to significantly inferior survival after an allogeneic hematopoietic cell transplantation. Recipient CMV seropositive status was associated with the risk of CMV viremia and CMV disease, and this was not abrogated with the use of Letermovir prophylaxis.

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来源期刊

Transplant immunology 医学-免疫学

CiteScore

2.10

自引率

13.30%

发文量

198

审稿时长

48 days

期刊介绍： Transplant Immunology will publish up-to-date information on all aspects of the broad field it encompasses. The journal will be directed at (basic) scientists, tissue typers, transplant physicians and surgeons, and research and data on all immunological aspects of organ-, tissue- and (haematopoietic) stem cell transplantation are of potential interest to the readers of Transplant Immunology. Original papers, Review articles and Hypotheses will be considered for publication and submitted manuscripts will be rapidly peer-reviewed and published. They will be judged on the basis of scientific merit, originality, timeliness and quality.